For clinical purposes the primarily impotent man arbitrarily has been defined as a male or penis never able to achieve and/or maintain an erection quality sufficient to accomplish successful coital connection. If erection is established and then lost under the influence of real or imagined distractions relating to coital opportunity, the erection usually is dissipated without accompanying ejaculatory response.

NO man is considered primarily impotent if he has been successful in any attempt at intromission in either heterosexual or homosexual opportunity.

the 11 years of the investigative program in sexual inadequacy 32 primarily impotent males have been accepted for treatment. Of these, 21 were unmarried when seen in therapy; 4 of the 21 men have histories of prior marriage contracts with either an annulment or a divorce legally attesting to their failures in sexual performance. The remaining 11 primarily impotent men were married when referred to the Foundation with their wives in the hope of consummating their marriages. These unconsummated marriages have ranged from 7 month to 18 year duration.

Negation of the young male's potential for effective sexual functioning has been thought to originate almost entirely in derogatory influences of family background. Without denying the importance of familial investment, the natural social associations of the adolescent as he ventures from his security base are also statistically of major importance.

The etiological factors that are in large measure responsible for individually intolerable levels of anxiety either prior to or during initial attempts at sexual connection are untoward maternal influences, psychosocial restrictions originating with religious orthodoxy, involvement in homosexual functioning, and personal devaluation from prostitute experience.

It always must be borne in mind that multiple etiological factors usually are influencing the primarily impotent male. Categorical assignment of a dominant etiological role is purely an arbitrary professional decision. Others might differ significantly were they to review the same material. Case histories have been kept at a didactic level for illustrative purposes.